Boullin Pam, Ellwood Christina, Ellis Jason G
Northumbria Sleep Research Laboratory, Northumbria University, Newcastle-upon-Tyne NE18ST, UK.
Brain Sci. 2016 Dec 23;7(1):1. doi: 10.3390/brainsci7010001.
Despite undeniable evidence for the efficacy and effectiveness of Cognitive Behaviour Therapy for Insomnia (CBT-I), the potential for its widespread dissemination and implementation has yet to be realised. A suggested reason for this is that traditional CBT-I is considered too burdensome for deployment, in its current form, within the context of where it would be most beneficial-Primary Care. One strategy, aimed to address this, has been to develop briefer versions of CBT-I, whilst another has been to deliver CBT-I in a group format. An alternative has been to attempt to address insomnia during its acute phase with a view to circumventing its progression to chronic insomnia. The aim of the present study was to compare a brief version of CBT-I (one-shot) when delivered individually or in groups to those with acute insomnia.
Twenty-eight individuals with acute insomnia (i.e., meeting full DSM-5 criteria for insomnia disorder for less than three months) self-assigned to either a group or individual treatment arm. Treatment consisted of a single one-hour session accompanied by a self-help pamphlet. Subjects completed measures of insomnia severity, anxiety and depression pre-treatment and at one-month post-treatment. Additionally, daily sleep diaries were compared between pre-treatment and at the one-month follow up.
There were no significant between group differences in treatment outcome on any sleep or mood measures although those in the group treatment arm were less adherent than those who received individual treatment. Furthermore, the combined (group and individual treatment arms) pre-post test effect size on insomnia symptoms, using the Insomnia Severity Index, was large ( = 2.27).
It appears that group treatment is as efficacious as individual treatment within the context of a "one shot" intervention for individuals with acute insomnia. The results are discussed with a view to integrating one-shot CBT-I in Primary Care.
尽管认知行为疗法治疗失眠（CBT-I）的有效性和效果有不可否认的证据，但其广泛传播和实施的潜力尚未实现。一个可能的原因是，传统的CBT-I在其最有益的初级保健环境中，以其目前的形式被认为部署起来过于繁琐。一种旨在解决这一问题的策略是开发更简短的CBT-I版本，另一种策略是采用小组形式提供CBT-I。另一种选择是试图在急性期解决失眠问题，以避免其发展为慢性失眠。本研究的目的是比较单独或分组提供给急性失眠患者的简短版CBT-I（一次性治疗）。
28名急性失眠患者（即符合《精神疾病诊断与统计手册》第5版失眠障碍完整标准少于三个月）自行分配到小组或个体治疗组。治疗包括一个小时的单次治疗，并配有一本自助手册。受试者在治疗前和治疗后一个月完成失眠严重程度、焦虑和抑郁的测量。此外，比较了治疗前和一个月随访时的每日睡眠日记。
在任何睡眠或情绪测量指标上，两组之间的治疗结果没有显著差异，尽管小组治疗组的依从性低于接受个体治疗的组。此外，使用失眠严重指数，合并（小组和个体治疗组）治疗前后失眠症状的效应量很大（=2.27）。
在对急性失眠患者的“一次性”干预中，小组治疗似乎与个体治疗一样有效。讨论了这些结果，以期将一次性CBT-I纳入初级保健。
